Provider Demographics
NPI:1710167416
Name:JEX, CHRISTOPHER JORDAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JORDAN
Last Name:JEX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19201 108TH AVE SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-7379
Mailing Address - Country:US
Mailing Address - Phone:253-859-6441
Mailing Address - Fax:253-859-6441
Practice Address - Street 1:19201 108TH AVE SE
Practice Address - Street 2:SUITE 101
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-7379
Practice Address - Country:US
Practice Address - Phone:253-859-6441
Practice Address - Fax:253-859-9437
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor